Osteoarthritis

Osteoarthritis is a very common condition that causes joints to become painful, sometimes swollen, stiff and the range of movement reduced.

Management of osteoarthritis usually begins with conservative, non-surgical approaches, which may include:

1. Lifestyle modifications: symptoms can be helped by ensuring strength and stability around the affected joint/s, adapting movement patterns to support
the health of your joints and maintaining a healthy weight.
2. Physical therapy: A therapist can design a personalised exercise programme to improve joint function, strengthen muscles, and enhance flexibility.
3. Medications: Paracetamol, nonsteroidal anti-inflammatory drugs (NSAIDs), and other medications may be prescribed to manage pain and inflammation.
4. Mobility devices: Using Nordic walking poles, canes, certain braces and custom made insoles can help to support joints and alleviate symptoms.
5. Injections: Corticosteroid, hyaluronic acid, Rich Pla Pla and Arthrosamid injections

Surgery is generally considered when conservative treatments are no longer effective, and the individual experiences significant pain and disability. Surgical options for osteoarthritis include:

1. Arthroscopy: A minimally invasive procedure to remove or repair damaged
cartilage.
2. Joint replacement: In severe cases, joint replacement surgery may be recommended, where the damaged joint is replaced with an artificial one.

The decision for surgery depends on factors such as the severity of your symptoms, the impact on your daily life, and how well you respond to non-surgical treatments. It is crucial to have a thorough discussion with our medical consultants, who can evaluate your condition and guide you in making an informed decision based on your specific circumstances.

Osteoarthritis can cause various types of pain, the severity and nature of the pain can vary from person to person. The primary source of pain is associated with the loss of cartilage covering the joint, resulting in increased friction and stress on the bones. Here are some of the common types of pain experienced in osteoarthritis:

1. Joint Pain: Pain is often localized to the affected joints. It can range from a dull ache to a sharp, stabbing pain. Joint pain is typically worsened by movement and weight-bearing activities.
2. Stiffness: This is generally felt after periods of inactivity or rest. Morning stiffness is a common complaint which then eases with movement.
3. Swelling: When the joint lining is inflamed this can result in swelling which
causes pain and reduced range of motion.
4. Tenderness: The affected joints may be tender to the touch and so pressing on or around the joint can cause pain.
5. Reduced Range of Motion: As the disease progresses, the range of motion in the affected joints may decrease which can impact on daily activities.
6. Bone Spurs: Osteoarthritis can lead to the development of bone spurs (osteophytes) around the affected joints and these can cause pain if they impinge on nearby tissues or nerves.
7. Pain with Activity: Pain often increases during or after activities that involve the affected joints, such as walking, climbing stairs, or carrying heavy objects.
It’s important to note that the pain associated with osteoarthritis can be episodic, with periods of flare-ups and relative relief. Additionally, individuals with osteoarthritis may experience changes in symptoms over time.

If you are experiencing pain consistent with osteoarthritis or if you suspect you have the condition, it is crucial to consult with one of our consultants or therapists. They can assess your symptoms, perform necessary tests, and recommend appropriate treatments to help manage pain and improve your quality of life.

Management of osteoarthritis usually begins with conservative, non-surgicalapproaches, which may include:

1. Lifestyle modifications: symptoms can be helped by ensuring strength and stability around the affected joint/s, adapting movement patterns to support the health of your joints and maintaining a healthy weight.
2. Physical therapy: A therapist can design a personalised exercise programme to improve joint function, strengthen muscles, and enhance flexibility.
3. Medications: Paracetamol, nonsteroidal anti-inflammatory drugs (NSAIDs), and other medications may be prescribed to manage pain and inflammation.
4. Mobility devices: Using Nordic walking poles, canes, certain braces andcustom made insoles can help to support joints and alleviate symptoms.
5. Injections: Corticosteroid, hyaluronic acid, Rich Pla Pla and Arthrosamid injections may be used to reduce inflammation and improve joint
function.
6. Nerve ablation: Radiofrequency ablation is used for severe cases of osteoarthritis where pain limits enjoyment of day to day life. It is used when patients are unfit for surgery or they don’t want surgery, and when they nolonger respond to the above treatment options. This approach aims to disrupt pain signals from the affected joints.

Surgery is generally considered when conservative treatments are no longer effective, and the individual experiences significant pain and disability. Surgical options for osteoarthritis include:
1. Arthroscopy: A minimally invasive procedure to remove or repair damaged cartilage.
2. Joint replacement: In severe cases, joint replacement surgery may be recommended, where the damaged joint is replaced with an artificial one.

Research into the management of OA is ongoing and here are some established and emerging conservative treatments:

1. Rich Pla Pla (RPR) Therapy: RPR involves injecting a platelet rich concentrate of the patient's own blood into the affected joint. A course of two to three injections is usually required. Recent studies show promising outcomes on symptoms and function, although more research is needed to establish its efficacy.
2. Arthrosamid Injection: a non-biodegradable injectable implant that integrates into the synovial tissue within the joint capsule to reduce inflammation and pain. This is an innovative option with clinical trials demonstrating improvement in symptoms, mobility and quality of life.
3. Nerve Ablation: Radiofrequency abl ation and other nerve-modulating techniques are being investigated for their potential in managing pain
associated with osteoarthritis. These approaches aim to disrupt pain signals from the affected joints. At Back and Body Medical we use radiofrequency ablation for severe cases that are no longer responding to our other treatments and where pain limits enjoyment of day-to-day life. It is usually
reserved for patients that are not suitable or unfit for surgery or they have actively chosen to not have surgery.
4. Wearable Technology and Digital Therapeutics: Advances in wearable devices and digital therapeutics may offer new ways to monitor and manage osteoarthritis symptoms. These technologies can provide real-time data on joint movement, offer personalised exercise programmes, and track the
effectiveness of interventions.
5. Biologics and Disease-Modifying Osteoarthritis Drugs (DMOADs): Researchers are investigating biologic drugs and DMOADs that target specific
molecules that modify the progression of the disease.
6. Stem Cell Therapy: Stem cell treatments involve the use of mesenchymal stem cells to promote tissue repair and regeneration. Early research and
clinical trials are exploring their use for osteoarthritis and more evidence is needed to determine its safety and effectiveness.
7. Autologous microfragmented adipose tissue (AMAT or MFAT): Fat, which contains stem cells, is removed by liposuction and microfragmented before being injected into the affected joint. There are variable protocols used with varying outcomes and more robust evidence is needed to determine its safety and effectiveness.
8. Genetic Therapies: Some researchers are exploring genetic approaches to target the underlying causes of osteoarthritis. This includes gene therapy and gene editing techniques to modify or repair damaged joint tissues. More evidence is needed to determine its safety and effectiveness.

Back and Body Medical currently offer the first three options and whilst the other treatments show promise many of these are not routinely offered outside of a clinical trial. It is crucial to have a thorough discussion with our consultants, who can evaluate your condition and guide you in making an informed decision based on your specific circumstances.

Injections can be a part of the personalised and holistic treatment plan for osteoarthritis. The choice of injection and its effectiveness can depend on the
specific symptoms, grade of osteoarthritis and joints affected. Here are some common types of injections used for osteoarthritis:

1. Corticosteroid Injections: These injections contain corticosteroids, which are powerful anti-inflammatory medications. They can provide relief from pain and inflammation in the affected joint. However, the effects are usually temporary, and repeated injections generally have diminishing returns.
2. Hyaluronic Acid Injections: Hyaluronic acid is a substance that occurs naturally in joint fluid. In osteoarthritis, the concentration of hyaluronic acid
decreases. Injections of synthetic hyaluronic acid can help lubricate and cushion the joint, often reducing pain and inflammation and improving joint
function.
3. Rich Pla Pla (RPR) Therapy: RPR involves injecting a platelet rich concentrate of the patient's own blood into the affected joint. Platelets contain growth factors that may promote healing and reduce inflammation. A course of two to three injections is usually required. Recent studies show promising outcomes on symptoms and function, although more research is needed to establish its efficacy.
4. Arthrosamid Injections: This is a non-biodegradable injectable implant that integrates into the synovial tissue within the joint capsule to reduce
inflammation and pain. This is an innovative option with clinical trials demonstrating improvement in symptoms, mobility and quality of life.

Injections can provide relief from symptoms but they may not alter the underlying progression of osteoarthritis. The choice of treatment, including injections, depends on factors such as the severity of symptoms, the affected joints, and individual health considerations.

Before undergoing any injection or treatment, it is crucial to consult with a consultant. They can evaluate your specific condition, discuss the potential benefits and risks of different options, and create a personalised treatment plan tailored to your needs.

They will often recommend a combination of treatments, including medications, physical therapy, and lifestyle modifications, to manage osteoarthritis effectively.

There is substantial evidence supporting the use of physical activity and personalised exercise programmes in managing osteoarthritis (OA). They are
considered a fundamental, non-pharmacological treatment for OA, and numerous studies have demonstrated their effectiveness in improving symptoms, function, and quality of life in individuals with osteoarthritis.

The decision between physiotherapy and osteopathy for osteoarthritis often depends on individual preferences, the severity of your symptoms, and the recommendations of your consultant or GP. Both physiotherapy and osteopathy can be beneficial in managing osteoarthritis, but they approach treatment in different ways.

1. Physiotherapy:
Focus: Physiotherapy aims to improve mobility, strength, and function in the affected joints. It often involves a combination of exercises stretches, and other therapeutic modalities.
Exercise Programmes: Physiotherapists can design personalised exercise programme to strengthen the muscles around the affected joints, improve flexibility, and enhance overall joint function.Education: Physiotherapists can provide education on proper body mechanics, joint protection techniques, and lifestyle modifications to manage osteoarthritis symptoms.
Pain Management: Physiotherapy may include modalities such as heat or cold therapy to help manage pain and inflammation.

2. Osteopathy:
Focus: Osteopathy is a manual therapy that emphasises the holistic approach to health, with a focus on the musculoskeletal system. Osteopaths use hands-on techniques to improve joint mobility, reduce muscle tension, and enhance circulation.
Manual Techniques: Osteopaths use a variety of manual techniques, including soft tissue manipulation, joint mobilisation, and gentle stretching, to address musculoskeletal issues.
Whole Body Approach: Osteopathy often involves considering the entire body and how different systems may be interconnected. Osteopaths may assess and treat not only the affected joint but also other areas that may contribute to symptoms.

Ultimately, the choice between physiotherapy and osteopathy may come down to personal preference and the recommendations of your healthcare professional. In some cases, individuals may benefit from a combination of both approaches for comprehensive care.